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  • 1
    Electronic Resource
    Electronic Resource
    Anterior cruciate-injured knees: a review of evaluation methods and treatment regimens (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Scandinavian journal of medicine & science in sports 3 (1993), S. 0 
    Details
    ISSN: 1600-0838
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Sports Science
    Notes: Functional scores, activity scores, objective clinical findings and results after arthrometric measurements performed by the same examiner give valuable information when evaluating results after treatment of anterior cruciate ligament (ACL) injuries. Patient relaxation is of considerable importance during the arthrometric examination and the results between different measuring devices cannot be compared directly. The difference in anterior laxity between the injured and uninjured knee is the most important information when arthrometric measurements are to be presented. In the acute phase, if surgery is indicated, augmentation-reconstruction with use of autologous material is the method of choice. The operation should be postponed until the knee has a full range of motion and when the effusion has subsided. Reconstruction using autologous patellar tendon bone-tendon-bone grafts and fixation techniques with use of interference-screws in both recent and old injuries, permitting early knee rehabilitation, seem to be methods of choice. In selected cases hamstring tendons should be used as grafts. Adequate notchplasty should always be considered. Both modern miniarthrotomy techniques or arthroscopically assisted reconstruction procedures minimize postoperative morbidity and facilitate knee rehabilitation. Future prospective randomized studies comparing these two methods, with special reference to aspects of postoperative rehabilitation and long-term results concerning function and stability, will certainly be valuable. Extra-articular stabilization procedures do not function in the long-term and these methods cannot be recommended as the only surgical procedure. There is as yet no true prosthetic ACL implant that has proven long-lasting satisfactory results. Most long-term reports about reconstruction of the ACL with synthetic materials have presented a high rate of failures. Augmentation techniques in which a synthetic material is combined with autologous tissue seem to give positive results, and resorbable materials may be a future solution. Use of allografts, either fresh-frozen or freeze-dried, are interesting techniques but must be considered developmental. Allograft techniques may enhance knee rehabilitation and minimize anterior knee pain, provided that the grafts are prepared properly and no viral infection is transmitted. Patient selection for either conservative or operative treatment is of greatest importance for good results. Each case should be treated individually, and in the future hopefully there will be better objective methods for selecting the right patient for the right method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0838.1993.tb00354.x
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  • 2
    Electronic Resource
    Electronic Resource
    Outcome of patients with anterior cruciate ligament injuries selected for conservative treatment (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Scandinavian journal of medicine & science in sports 1 (1991), S. 0 
    Details
    ISSN: 1600-0838
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Sports Science
    Notes: In this retrospective study, 24 patients with acute isolated complete anterior cruciate ligament (ACL) ruptures selected for conservative treatment were re-examined a median of 45 months after injury. Selection for conservative treatment was made after careful patient information, taking into consideration desire for physical activity at work or leisure, interest in sports and muscular fitness. The reference group for the evaluation methods used included 50 students and 22 patients selected for surgical augmentation and reconstruction. In a subjective evaluation, the conservatively treated patients were satisfied, but objectively they had low functional scores and the pivot shift sign was often positive. Arthrometry showed that these patients had an increased anterior displacement of the tibia in relation to the femur in their injured knees. The patients who had a clearly positive pivot shift sign (grades III and IV) had an increased anterior laxity not only in the injured knees but also in the uninjured knees.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0838.1991.tb00304.x
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  • 3
    Electronic Resource
    Electronic Resource
    Bone and muscle mass after femoral neck fracture (1997)
    Springer
    Archives of orthopaedic and trauma surgery 116 (1997), S. 470-474 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh, and the BMD of the distal femur and proximal tibia were measured quantified by quantitative computed tomography (QCT) after an operation for a displaced femoral neck fracture. Twenty patients were randomized to osteosynthesis or total hip arthroplasty (THA). Both legs were scanned after 18 months, and the operated side was compared with the healthy side. Clinical assessment was performed with a Harris hip score. A reference group of 9 patients, who had undergone THA because of arthrosis, was chosen. In the fracture patients, we found a 9% decrease in bone mass and muscle volume of the middle femur. The BMD of the distal femur and proximal tibia showed a more marked osteopenia. There was no difference in these parameters between the two groups. In the reference group of operated arthrosis patients, we did not find any differences between sides postoperatively. After the operation, the fracture patients had a lower Harris score than the arthrosis patients, and this was most pronounced among those who had undergone osteosynthesis. The finding of a marked osteopenia after a femoral neck fracture, irrespective of treatment, but no bone loss after THA because of arthrosis, implies that patients with a femoral neck fracture are more sensitive to osteopenia, and that the bone loss is not proportional to the operative trauma. caused by the disuse and the posttraumatic effect on the bone caused by the operation. Also, the magnitude of the operative trauma may play a role in the development of the osteopenia. Thus, a displaced femoral neck fracture, treated with osteosynthesis or total hip arthroplasty (THA), offers a possibility to distinguish between the osteopenia caused by the fracture and the role of the operation, since the degree of the operative trauma is different. The aim of this study was to investigate whether or not the bone loss after a displaced femoral neck fracture depends on the mode of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00387579
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  • 4
    Electronic Resource
    Electronic Resource
    Bone and muscle mass after femoral neck fracture (1997)
    Springer
    Archives of orthopaedic and trauma surgery 116 (1997), S. 470-474 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh, and the BMD of the distal femur and proximal tibia were measured quantified by quantitative computed tomography (QCT) after an operation for a displaced femoral neck fracture. Twenty patients were randomized to osteosynthesis or total hip arthroplasty (THA). Both legs were scanned after 18 months, and the operated side was compared with the healthy side. Clinical assessment was performed with a Harris hip score. A reference group of 9 patients, who had undergone THA because of arthrosis, was chosen. In the fracture patients, we found a 9% decrease in bone mass and muscle volume of the middle femur. The BMD of the distal femur and proximal tibia showed a more marked osteopenia. There was no difference in these parameters between the two groups. In the reference group of operated arthrosis patients, we did not find any differences between sides postoperatively. After the operation, the fracture patients had a lower Harris score than the arthrosis patients, and this was most pronounced among those who had undergone osteosynthesis. The finding of a marked osteopenia after a femoral neck fracture, irrespective of treatment, but no bone loss after THA because of arthrosis, implies that patients with a femoral neck fracture are more sensitive to osteopenia, and that the bone loss is not proportional to the operative trauma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00387579
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  • 5
    Electronic Resource
    Electronic Resource
    No effects of piroxicam on osteopenia and recovery after Colles' fracture (1993)
    Springer
    Archives of orthopaedic and trauma surgery 112 (1993), S. 127-130 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a randomized double-blind study involving 42 postmenopausal women with a displaced Colles' fracture, we investigated whether piroxicam, a nonsteroid anti-inflammatory drug, can reduce posttraumatic osteopenia and improve the rate of recovery. In an earlier study [3] we found a bone-sparing effect caused by piroxicam after external fixation of the rabbit hindleg. The patients were treated with a below-elbow paster slab for 4 weeks after the reduction. The bone mineral content of the forearm bones was measured with a single-photon absorptiometer 8 weeks after the fracture. There was a mean 7% bone mineral decrease in the radius and 5% in the ulna among the patients treated with piroxicam versus 10% in the radius and 7% in the ulna in the placebo group. However, this difference was not significant. Piroxicam did not decrease the rate of fracture healing. The patients who received piroxicam had significantly less pain during plaster treatment, but there was no difference in the rate of functional recovery between the groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00449987
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  • 6
    Electronic Resource
    Electronic Resource
    Trabecular patterns of the calcaneum as an index of osteoporosis (1993)
    Springer
    International orthopaedics 17 (1993), S. 266-268 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Des mesures par gamma-absorptiométrie du contenu minéral osseux (CMO) du calcanéum ont été effectuées chez 77 patients opérés de fractures du cou-de-pied et comparées à l'index d'ostéoporose du calcanéum, calculé à l'aide de simples radiographies de profil. Bien que les mesures du CMO aient été largement réparties, l'index d'ostéoporose du calcanéum n'a révélé qu'une étroite répartition avec seulement des taux très élevés. Nous n'avons trouvé qu'une faible corrélation entre l'index du calcanéum et le CMO du côté fracturé, mais pas de corrélation ou une corrélation très faible du côté opposé. Il n'y a pas non plus de corrélation entre la diminution de l'index du calcanéum et la perte du CMO du côté atteint. En conclusion, l'index d'ostéoporose ne permet pas de déterminer le CMO du calcanéum, ni de détecter les ostéoporoses post-traumatiques.
    Notes: Summary Measurements of bone mineral content in the calcaneum were made by gamma-absorptiometry in 77 patients with ankle fractures treated by operation, and compared with the calcaneal osteoporosis index [1]. The index was calculated from plain lateral radiographs of the calcaneum. The bone mineral measurements showed a wide range, but there was only a narrow range of the index with exclusively high values. There was a weak correlation between the calcaneal index and the bone mineral content in the injured ankles, but no or only a very poor correlation in the uninjured ankles. We also found no correlation between the decline in index and loss of mineral content in the injured ankles.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00194193
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  • 7
    Electronic Resource
    Electronic Resource
    Serum albumin and deep infection in femoral neck fractures (1998)
    Springer
    International orthopaedics 22 (1998), S. 182-184 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Nous avons étudié rétrospectivement 437 patients avec des fractures du col fémoral pour re- trouver la présence des infections profondes et des facteurs prédictifs de línfection postoperative et de la mortalité. Le nombre de cas d’infection se montant à 3% ne motive pas un traitment antibiotique prophylactique en général. Le tauxe de sérum-albumine prédit bien la mortalité mais pas les infections postoperatoires.
    Notes: Summary. Four hundred and thirty-seven patients with femoral neck fractures were studied to determine the value of serum albumin estimations on admission. Serum albumin is a good predictor of mortality, and patients with low levels should be given additional nutritional support. We found that the serum albumin level is not useful in predicting deep wound infection. The infection rate of 3% does not justify the use of antibiotic prophylaxis in general.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002640050237
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  • 8
    Electronic Resource
    Electronic Resource
    Coxarthrosis and labour (1987)
    Springer
    International orthopaedics 11 (1987), S. 311-313 
    Details
    ISSN: 1432-5195
    Keywords: Ostearthritis ; Hip ; Aetiology ; Labour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Pour savoir si les contraintes extérieures peuvent contribuer au déveleloppement de la coxarthrose, on a interrogé au sujet de leur métier 85 malades atteints de coxarthrose primitive ainsi que 262 malades urologiques masculins. L'importance de l'atteinte de leurs hanches a été appréciée sur les radiographies. Les malades présentant une coxarthrose avaient exercé plus fréquemment des travaux de force, avec soulèvement de poids lourds et pour beaucoup conduite de tracteurs. Nos résultats montrent que les efforts entraînés par les modes de vie et les métiers divers peuvent jouer un rôle dans l'apparitation de la coxarthrose.
    Notes: Summary To investigate whether environmentally associated stress may contribute to the development of coxarthrosis, 85 males with primary coxarthrosis and 262 male urological patients were questioned about their occupation, and their hips were graded radiologically. Patients with coxarthrosis had been more frequently exposed to heavy labour, heavy lifting, and much tractor driving. Our results indicate that environmentally associated stress, as reflected by a varied life style or occupation, may contribute to the development of coxarthrosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271306
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  • 9
    Electronic Resource
    Electronic Resource
    Factors influencing the incidence of reoperation after femoral neck fractures (1985)
    Springer
    International orthopaedics 9 (1985), S. 235-237 
    Details
    ISSN: 1432-5195
    Keywords: Femoral head viability ; Femoral neck fractures ; Fracture displacement ; impaction ; Osteoporosis ; osteosynthesis ; Reoperation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Ce travail compare deux groupes de malades présentant une fracture du col du fémur: 22 ayant dû être réopérés et 72 non. On a particulièrement étudié l'ostéoporose, le redéplacement de la fracture, la vitalité de la tête fémorale, la réduction avec compression peropératoire et le type d'ostéosynthèse: par un clou de Thornton ou trois broches de Scand. On a mis en évidence une différence significative (p〈0.01) entre les deux groupes en ce qui concerne l'ostéoporose, le redéplacement de la fracture et la vitalité de la tête du fémur. Les broches de Scand comparées aux clous de Thornton ont montré une tendance (p〈0.1) à déterminer moins de réinterventions. La compression ou l'absence de compression peropératoire n'ont entraîné aucune différence.
    Notes: Summary This investigation compares two groups of patients with fractures of the femoral neck: 22 required a further operation and 72 did not. Special attention was paid to osteoporosis, the displacement of the fracture, viability of the femoral head, operative impaction and osteosynthesis with a Thornton nail or three Scand hip pins. There was a significant (p〈0.01) difference between the two groups with regard to osteoporosis, fracture displacement and viability of the femoral head. Scand hip pins, as compared to Thornton nails, showed a tendency (p〈0.1) to need a smaller number of reoperations. Operative impaction compared with no impaction showed no difference.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00266509
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